Kornimate/medical-research-clean huggingface dataset:
understanding mechanisms of exercise behavior change

Conditions: Overweight and Obesity; Physical Activity; Incentives

Summary: this research seeks to examine psychological factors that may impact relationship between incentives and health behavior engagement, specifically physical activity. additionally, it will compare the impact of two different incentive schedules on behavior engagement, one providing immediate rewards (i.e. rewards received on a daily basis) and another providing delayed rewards (i.e. rewards received at the end of the study period), with an active self-monitoring intervention condition in which no rewards are offered. study participants will provide reports of their physical activity each day for three weeks, and in the two incentive conditions, they will receive small monetary rewards for their physical activity. following the three week reporting and reward period, participants will complete two additional assessments, measuring psychological constructs and behavior engagement following the cessation of rewards. the study will also examine how cognitive and anthropomorphic factors may contribute to intervention response and the effects on psychological constructs.


Eligibility criteria:
inclusion criteria: * complete less than 150 minutes of moderate-vigorous physical activity weekly * daily access to the internet for 3 weeks following baseline research visit * have or are willing to create an account on paypal * willing to wear a heart rate monitor watch during physical activity for 3 weeks * bmi greater than or equal to 25, from self-reported height and weight exclusion criteria: * diagnosis of cardiovascular, metabolic, or renal disease

Keywords: overweight obesity physical activity exercise
intracoronary tirofiban on no-reflow phenomena

Conditions: No-Reflow Phenomenon

Summary: the goal of this study was to evaluate the acute effect of intracoronary administration of tirofiban on no-reflow phenomenon in patients with stemi and occurrence of no-reflow phenomenon undergoing primary percutaneous coronary intervention (pci).

the no-reflow phenomenon is one of the most common causes of adverse cardiovascular events in patients with st-elevated myocardial infarction (stemi). re-canalization of infarct related arterial (ira) flow related to better ventricular performance and lower mortality rate in patients with stemi. in addition, no-reflow phenomena may limit the benefits of re-canalization of the ira. in recent years, many mechanical or pharmacological treatment strategies including adjunctive administration of glycoprotein iib/iiia inhibitors (gpi) have been proposed in patients with stemi. although current guidelines recommend that small molecule gpi should be administered as an upstream bolus followed by a continuous infusion in patients with stemi, changes in clinical practice may obviate the need for gpi dosage or routes in current practice. previous studies have shown that intravenous and intracoronary administration of gpi improve the prognosis and significantly reduce mortality in patients with stemi. recently, the ongoing tirofiban in myocardial infarction evaluation-2 (on-time 2) trial found that the use of tirofiban started during the pre-hospital phase as upstream therapy for primary percutaneous coronary intervention (pci) and continued for up to 18 hours infusion after the procedure showed an improvement in the markers of reperfusion. additionally, a reduction was demonstrated in the death in recurrent myocardial infarction in urgent target vessel revascularization and thrombotic bailout. however, in the current literature there are insufficient data regarding the role of intracoronary administration of gpi inhibitors in patients with stemi who developed the no-reflow phenomenon. the goal of this study was to evaluate the acute effect of intracoronary administration of tirofiban on no-reflow phenomenon in patients with stemi and occurrence of no-reflow phenomenon undergoing primary pci.

Eligibility criteria:
inclusion criteria: - patients with st-elevated myocardial infarction who developed no-reflow phenomena exclusion criteria: * treatment with thrombolytic drugs in the previous 24 hours * known malignancy * pain to balloon time \>6 hours * uncontrolled hypertension (\>180/110 mmhg) * bleeding diathesis * thrombocytopenia * end-stage liver disease * cardiogenic shock * renal failure * life expectancy of less than 1 year * contraindication for the use of tirofiban.

Keywords: no-reflow phenomenon, tirofiban, intracoronary
blood loss measurement during cesarean delivery

Conditions: Pregnancy

Summary: the aim of this study is to assess the ability of the triton device to measure blood loss among women undergoing elective and non-elective cesarean delivery. this patient population often experiences significant blood loss during surgery, and measurements of surgical blood loss are often inaccurate.

this is an observational study. potential participants will be approached by a member of the research team prior to surgery. healthy asa 1, 2, or 3 patients undergoing uncomplicated cesarean delivery will be recruited. the triton device will be used during the surgery to estimate blood loss. specifically, the device takes pictures of the blood saturated laps and fluid collection canister and calculates hemoglobin loss and overall blood loss. serum hemoglobin samples will be collected at baseline on presentation to the pre-operative area, within 15 mins of arrival in pacu and at 24 hrs post cesarean delivery. blood sampling will take place by venipuncture technique from a vein in the arm. maternal vital signs during the perioperative period (heart rate, maternal mean arterial blood pressure, anesthetic technique, fluid administration, and surgical data will be recorded. all patient will have a neuraxial anesthetic of a spinal or combined spinal/epidural. fluid administration will be under the discretion of the anesthesiologist and will follow standard guidelines including 1l of lactated ringers co-load at time of spinal and 1-2l of crystaloid intraoperatively. at the end of the cesarean section, the following measurements will be made: 1. tebl: triton device will be used to measure blood loss on wet and dry soaked laps and in the suction canister. these measurements will be used to calculate tebl. 2. vebl: the attending obstetrician and anesthesiologist will independently be asked to provide estimates for total blood loss (vebl). we will use both values in separate regression analyses 3. qebl: blood loss will be measured by cumulative measurement of the following: the volume of blood in the suction chamber at the end of surgery (and subtracting the estimated amniotic fluid from the suction chamber; weight of blood soaked laps; estimated spillage of blood (in ml) in and around the surgical field (not collected on laps or in suction chamber). using mixed effects modeling, we will determine whether estimated blood loss measurements using triton (tebl) can be used to predict postpartum hemoglobin (hb) levels, after accounting for the predelivery hb level, intraoperative intravenous fluids and patient/operative factors.

Eligibility criteria:
inclusion criteria: * american society of anesthesiologists physical status class i-iii * undergoing cesarean delivery under neuraxial anesthesia * age between 18 and 50 * gestational age greater than or equal to 37 completed weeks * all ethnicities exclusion criteria: * contraindication for epidural or spinal analgesia (bleeding diathesis, neuropathy, severe scoliosis, local anesthetic allergy) * inability to adequately understand the consent form

Keywords: cesarean blood loss triton
using automated calls to improve compliance with acute coronary syndrome best practice guidelines

Conditions: Acute Coronary Syndrome; Medication Adherence

Summary: the purpose of this study is to determine whether interactive voice response (ivr) technology can be used to bring post discharge care for acute coronary syndrome (acs) closer to best practice guidelines (bpgs). the study hypothesis is that acs patients who are contacted by ivr technology will be more likely to receive care as recommended in the bpgs than those followed by usual care.

acute coronary syndrome (acs) is a significant public-health problem in canada and worldwide with 20,000 canadians dying of myocardial infarction and 42,000 dying of coronary artery disease in 1999. large clinical trials have provided evidence for the development of standardized best practice guidelines (bpg) and compliance with these guidelines have significantly improved survival. despite the development and dissemination of bpg, their application in patients with acs is suboptimal. this randomized control trial will use 2 groups: ivr and usual care. patients in the ivr group will receive 5 automated calls at 1,3,6,9 and 12 months consisting of predetermined questions related to medication management, smoking cessation, diet, exercise and education as recommended by the acc/aha bpg for acs. responses are captured in a database allowing for interventions to maintain patients on bpg as needed.

Eligibility criteria:
inclusion criteria: * patients discharged from the uohi with acs (acute myocardial infarction, stemi or nstemi) * patients who have a land line telephone service at home * patients who speak english or french exclusion criteria: * patients discharged to a care facility or transferred to another health care institution

Keywords: acs interactive voice response technology best practice guidelines health care utilization outcome assessment
myocardial hybrid revascularization versus coronary artery bypass grafting for complex triple-vessel disease

Conditions: Multivessel Coronary Artery Disease

Summary: this is a pilot randomized study that aim to assess the safety and feasibility of a hybrid myocardial revascularization strategy (coronary artery by-pass graft and percutaneous intervention) in comparison with conventional surgical coronary bypass grafting.


Eligibility criteria:
inclusion criteria: * triple-vessel disease with proximal or mid lad disease with angiographic diameter stenosis \> 70% by visual analysis in all three territories, requiring myocardial revascularization or triple-vessel disease with proximal or mid lad disease with angiographic diameter stenosis 50-70% by visual analysis in any territory but with invasive or non-invasive evidence of flow-limiting stenosis in all three territories, requiring myocardial revascularization * total syntax score \> 22 * lcx and rca territories estimated to be equivalently revascularized by either pci or cabg, with at least one major non-lad vessel to be treated * clinical and anatomic eligibility for both pci and cabg as agreed to by both interventional and surgical consensus * interventionalist determines pci appropriateness and eligibility * surgeon determines surgical appropriateness and eligibility * silent ischemia, stable angina, unstable angina or recent mi * if recent mi, cardiac biomarkers must have returned to normal prior to randomization * ability to sign informed consent and comply with all study procedures exclusion criteria: * prior pci or cabg at any time prior to randomization * need for any concomitant cardiac surgery other than cabg (e.g. valve surgery, aortic repair, etc.), or intent that if the patient randomizes to surgery, any cardiac surgical procedure other than isolated cabg will be performed * patients unable to tolerate, obtain or comply with dual antiplatelet therapy for at least one year * patients requiring additional surgery (cardiac or non cardiac) within one year * the presence of any clinical or anatomical condition(s) which leads the participating interventional cardiologist to believe that clinical equipoise is not present (i.e. the patient should not be treated by pci, but rather should be managed with cabg or medical therapy - reasons will be documented) * the presence of any clinical or anatomical condition(s) which leads the participating cardiac surgeon to believe that clinical equipoise is not present (i.e. the patient should not be treated by cabg, but rather should be managed with pci. or medical therapy - reasons will be documented) * non cardiac co-morbidities with life expectancy less than 1 year * other investigational drug or device studies that have not reached their primary endpoint.

Keywords: multivessel coronary artery disease hybrid revascularization
virtual reality exposure in spider phobia

Conditions: Specific Phobia; Cognitive-behavioral Therapy; Virtual Reality

Summary: while knowledge on the neurobiological signatures of fear and anxiety disorders and, in particular, their association with treatment outcome is accumulating, clinical translation still awaits empirical proof of evidence. exposure-based cognitive-behavioral therapy (cbt) is a first-line treatment, but clinically significant change is only seen in approx. 50-65% of patients. patient stratification is a powerful option to increase treatment response; however, developing prognostic markers suitable for single-patient predictions still is in its infancy and crucially requires external cross-validation embedded within an a priori prediction approach - a procedure yet largely missing in the field of biomarker research. employing a bicentric strategy the aim of this study is to test the hypothesis that a priori prediction of treatment outcome based on neurobiological measures is possible in a second, independent sample. building upon findings from previous mechanistic studies, these will be incorporated into the development of a predictive pattern comprising fear-relevant genotypes and molecules targeting neuropeptides, related epigenetic signatures as well as neurofunctional activation patterns associated with fear circuitry functions, and clinical data. pre-treatment neurobiological signatures will be tested for their potential as a predictive response marker towards behavioral exposure (virtual reality exposure treatment (vret) and an in vivo behavioral avoidance test) in a model disorder of fear circuitry dysfunctions (spider phobia). multivariate pattern analyses employing a machine learning framework will be used to generate predictions on the individual patient level and to cross-validate markers in a second, independent sample. while at site a predictions will be generated following completion of the treatment, response will be predicted at site b a priori, but in a double-blind manner. comparison of observed vs. predicted response rates will serve as a test of hypothesis. in addition, neuroplastic (on a subsample) and epigenetic changes induced by vret treatment will be assessed following treatment and, in case of epigenetics, also after 6-months follow-up.


Eligibility criteria:
inclusion criteria: * 18 or older * specific phobia (animal subtype: spider phobia) according to criteria of the diagnostic and statistical manual of mental disorders, 5th version (dsm-5) * right-handedness * caucasian descent * willingness to participate in massed exposure exclusion criteria: * patients exhibiting a primary other anxiety disorder (panic disorder, agoraphobia, social phobia, generalized anxiety disorder), acute suicidality, psychotic, bipolar i, obsessive-compulsive disorder, posttraumatic stress disorder, severe major depression, borderline personality disorder or substance dependency (except nicotine) * patients fulfilling mri-related exclusion criteria * patients with current pharmacological or psychotherapeutic treatment, as well as those already previously treated with exposure-based cbt * pregnancy or lactation
transarterial chemoembolization for unresectable hepatocellular carcinoma with portal vein tumor thrombosis

Conditions: Hepatocellular Carcinoma

Summary: transcatheter arterial chemoembolization (tace) had been proved to improve the survivals for middle stage hepatocellular carcinoma (hcc), but for advanced stage hcc its' efficacy had not been proved. the investigators hypothesize that tace also improve the survivals for advanced stage hcc. thus, the investigators carried out this prospective control study to find out if the survivals for patients after tace better than only best support or not.


Eligibility criteria:
inclusion criteria: * the diagnosis of hcc was based on the diagnostic criteria for hcc used by the european association for the study of the liver (easl) * tumor size \>7 cm with a portal vein invasion, and the tumor was considered to be unresectable * no previous hcc directed treatment * eastern co-operative group performance status 0-1 * liver function: child's a exclusion criteria: * avascular tumor * evidence of hepatic decompensation including ascites, gastrointestinal bleeding or hepatic encephalopathy * underlying serve cardiac or renal diseases * known or suspected allergy to the investigational agent or any agent given in association with this trial * diffuse-type hcc * for patients with main portal vein occlusion, no adequate collateral circulation around the occluded portal vein

Keywords: hepatocellular carcinoma transcatheter arterial chemoembolization prospective control study best support care survival
relapse-prevention booklets as an adjunct to a tobacco telephone helpline("quitline")

Conditions: Smoking Cessation

Summary: the study primary purpose is smoking relapse prevention. this study is a collaboration between researchers who developed the relapse-prevention intervention, at the h. lee moffitt cancer center in tampa, florida, and those associated with the "new york state smokers' quitline" (nyssql), at roswell park cancer institute in buffalo, new york.

in this study, approximately 3400 quitline clients will be randomized to one of three conditions at the point of their 2-week follow-up call. one-third will be randomized to a usual care (uc) condition, which will receive regular quitline services. one-third will be randomized to a repeated mailings (rm) condition, which will receive the 8 forever free booklets sent by mail at regular intervals over a period of 12 months. and one-third will be randomized to a massed mailings (mm) condition, which will receive all 8 booklets in a single mailing.

Eligibility criteria:
inclusion criteria: * referrals from the new york state smokers' quitline * at least 18 years of age

Keywords: self help smoking cessation cancer prevention
the one-mind study: evaluating the efficacy of online mindfulness-based cancer recovery during chemotherapy treatment

Conditions: Breast Cancer; Colorectal Cancer; Chemotherapy Effect

Summary: background: chemotherapy treatment (ct) can have burdensome side effects such as fatigue, nausea-vomiting, and sleep problems that can significantly affect patients' quality of life. fatigue is the most common, lasting and bothersome of these, which prevents people from working and carrying out daily activities. mindfulness-based cancer recovery (mbcr) is an evidence-based group training program which has shown to help treat negative physical and psychosocial symptoms in cancer patients. the investigators propose to evaluate a pilot-tested online-mbcr program for patients undergoing ct who may be low on energy, time or have compromised immunity. objectives: to evaluate the impact of participation in online mbcr during ct on fatigue (primary outcome), sleep, pain, nausea/vomiting, mood disturbance, stress symptoms and quality of life (secondary outcomes) as well as cognitive function and return to work (exploratory outcomes) over the course of treatment. methods: the study design is a randomized wait-list controlled trial, conducted during ct for patients with breast or colorectal cancer. participants will take the 12-week online mbcr program at home within 2 weeks of randomization (immediate group) or after ct completion (waitlist group). outcomes will be assessed online at, 1) baseline, 2) post-mbcr, 3) post-ct (primary outcome) and 4) 12 months post-baseline. anticipated findings: mbcr is a promising adjuvant program that could help patients prevent, delay or diminish aversive symptoms and side-effects associated with ct, particularly fatigue. if helpful, online-mbcr could be made easily available at cancer centers worldwide and significantly lessen the burden of cancer treatments.


Eligibility criteria:
inclusion criteria: 1. men and women over the age of 18 2. diagnosed with either a) stage i-iii her 2 normal breast carcinoma or b) stage ii-iii colorectal carcinoma 3. scheduled to undergo either neoadjuvant or adjuvant: a) fec- d or ac-t chemotherapy or b) folfox or capeox chemotherapy 4. weekly access to high-speed internet 5. access to a computer/tablet/smart phone 6. able to attend mbcr classes at scheduled times 7. sufficient ability to speak and read english 8. willingness to be randomized into immediate or waitlist groups and complete all assessments exclusion criteria: 1. metastatic patients 2. suffering from current major depressive disorder, bipolar disorder or other psychiatric disorder (self-report) 3. currently engaging in meditation one or more times per week within the previous year. 4. participation in an mbcr or mbsr program in the last five years. 5. cognitive impairment (\>6 on the brief screen for cognitive impairment) 6. physical functional impairment that would interfere with the ability to participate in the intervention (on the par-q questionnaire)
evaluation of the clinical and biological consequences of levothyrox® formula modification

Conditions: Thyroid Disorder

Summary: the purpose of this study is to determine whether the recent excipient modification of levothyrox® in france for a bioequivalent formula has clinical and biological consequence for the patients. the investigators also plan to describe the patient journey in terms of levothyroxine based drugs since this formula modification of levothyrox®.

levothyrox® is a levothyroxine based drug marketed in france in order to substitute a lack of thyroid hormones. because of a lack of stability during time and because of wide inter-batch variability in terms of active molecule, the national agency of safety of medicaments (ansm) ask to the market authorization holder to develop a new formula without lactose. this new formula, which has been proven to be bioequivalent has been marketed since march 2017 in france. some patients were predicted to have their thyroid function imbalance because of this modification. the purpose of the study is to analyse, on the patients treated by levothyroxine® in how many patients this modification has clinical and biological consequences.

Eligibility criteria:
inclusion criteria: * thyroid disorder treated by levothyroxine * age over 18 year old * tsh plasma level within the 12 months before formulation modification * tsh plasma level within the 6 months after formulation modification exclusion criteria: - thyroid dysfunction (hypo or hyperthyroidism) despite levothyroxine treatment, ie tsh plasma level out of normal range within the 6 months before formula modification

Keywords: levothyrox® thyroid hormones bioequivalent